Although malaria is endemic in India, congenital malaria is not very common. Congenital malaria is a very rare condition in both endemic and nonendemic areas. We report a case of congenital malaria in a six-day-old neonate with fever and splenomegaly. The diagnosis was picked up accidentally on a peripheral smear examination. Congenital malaria should be kept as differential diagnosis of neonatal sepsis. Timely detection of this condition could lead to early diagnosis and treatment, thereby preventing neonatal mortality.

Background: To assess the pregnancy rates using sequential day 3 and day 5 embryo transfer in IVF/ ICSI patients.Methods: This prospective study was conducted in Aarogya Hospital and test tube baby Centre, Raipur from 1st January 2013 to 30th November 2019. Total 100 patients undergoing IVF/ICSI in the study period were offered sequential transfer.Results: Our fertilization rates were 80% with 85.7% grade I embryos on day 3. Blastocyst formation rate was 71.42%. Cycle cancellation rates were nil. Clinical pregnancy rates per retrieval cycle were 50% and implantation rates were 24% with acceptable multiple pregnancy rates of 12%.Conclusions: We advocate that this technique is useful in all patients having good quality embryos in adequate number for double transfer as this optimizes the chance of selection of the most viable embryo for transfer which is probably the key for a successful IVF program.

Endometrial carcinoma (EC) most commonly presents with postmenopausal bleeding (PMB) or blood tinged vaginal discharge. Watery vaginal discharge is usually reported in fallopian tube malignancy. We reported a case of EC where she had profuse watery discharge from private part mimicking urine and so patient visited urologist for urinary incontinence and was later diagnosed as endometroid adenocarcinoma. A 73 year old female presented with history of passing urine involuntarily for last 3 months. Endometrial biopsy revealed endometrial endometroid adenocarcinoma-FIGO grade-2. FDG PET-CT scan revealed primary neoplastic pathology of uterus or endometrium with no lymphadenopathy. PMB or vaginal discharge in women with high risk factors like obesity, diabetes mellitus, unopposed oestrogen exposure needs prompt evaluation. PMB is highly suspicious of malignancy arising from cervix or uterus but copious watery discharge should also be evaluated thoroughly with ultrasound and confirmation of underlying malignancy with hysteroscopic guided endometrial sampling should be done.

Lethal skeletal dysplasia is estimated to occur in 0.95 per 10,000 deliveries. Thanatophoric dysplasia affects about 1in 25000 to 50000 births. The term thanatophoric is Greek word for “death bearing”. Children with this condition are usually stillborn or die shortly after birth from respiratory failure. We report a case of LSD (Thanatophoric dysplasia), in an unbooked patient where previous two children and couple were absolutely normal.  Our patient, 31 years old, unbooked case presented with history of amenorrhea 8 months and unable to perceive fetal movements. Her husband’s age was 33 years. This was her third pregnancy. She had previous 2 deliveries by LSCS. Ultrasonography revealed single intrauterine live fetus in breech presentation with multiple fetal anomalies. There was shortening and deformity of all four limbs (micromelia) with poor mineralization of all bones. Thorax was pear shaped with short horizontal ribs and abnormal cardiothoracic ratio. LSCS was done in emergency for impending rupture of previous LSCS scar. Post-delivery examination and X-ray of the fetus revealed decreased skull mineralization, frontal bossing, hypoplastic nasal bone, midface hypoplasia, mandibular hypoplasia, pear shaped chest, protuberant abdomen, micromelia, dumbbell shaped appearance of all long bones. TD is caused due to mutation of the fibroblast growth factor receptor 3 gene (FGFR3), which is located on the short arm of chromosome 4. Type I TD is characterized by marked underdeveloped skeleton and short-curved long bones. Conventional radiographic examination remains the most useful means of studying the dysplastic skeleton. Bony evaluation is best done on X-rays or ultrasonography. The diagnosis of TD can be established with ultrasound and molecular confirmation in the second trimester can help in genetic counselling and termination of such lethal pregnancies. LSD’s are rare event. If our patient had undergone anomaly scan in second trimester of pregnancy, this defect could have been detected earlier. The outcome of fetus is lethal but maternal morbidity can be reduced if diagnosed early.

Uterine torsion (UT) is defines as a rotation of the uterus of more than 45 degree on its long axis. The predisposing factors for UT can be uterine asymmetry due to fibroids or mullerian anomalies, foetal malpresentation, pelvic adhesions and abdominal or ligamentous laxity other possible causes include external cephalic version, maternal trauma and abdominal massage. The clinical presentation of UT is non-specific. We report a case of previous 2 CS where we suspected rupture uterus but intraoperatively it was UT with unruptured fibrosed scar of previous CS. A 31 years old, G3P2 presented in emergency department with history of amenorrhea 9 months and severe abdominal pain for 5-6 hours. She had previous 2 CS done for contracted pelvis. We immediately suspected rupture of previous CS scar. On laparotomy dense intra-abdominal adhesions were found. After adhesiolysis we could find any sign of previous scar on the visible uterine wall. Entire uterine wall seemed as if we were doing CS in a primiparous patient. This made us suspicious of UT. UT is considered rare and has been referred to as an ‘obstetrician’s once in a lifetime diagnosis’. Recently cases have been reported with no associated pelvic factors although a common feature in all these cases had been previous CS. UT is a potentially dangerous complication of pregnancy both to the mother and to the foetus. Maternal mortality in modern era highly unexpected event but maternal morbidity can occur because of complications like uterine rupture, uterine abruptio, sepsis, pulmonary embolism and iatrogenic complications like injury to blood vessels, urinary tract and rectum. During laparotomy where correction of UT is not possible, a deliberate posterior hysterotomy can be done for delivery of foetus. Bilateral plication of the round ligaments can be done to prevent immediate postpartum recurrence of UT. UT though rare should be kept in mind while performing CS in cases of previous CS, associated myomas, ovarian tumour, malpresentations of foetus. Clinical symptoms may be absent or nonspecific and the diagnosis may be intraoperative.